# Multi-View Stenosis Classification Leveraging Transformer-Based Multiple-Instance Learning Using Real-World Clinical Data

arXiv: https://arxiv.org/abs/2602.02067 · HTML: https://mlsanity.com/paper/2602.02067/

## Key facts

- Cited by 1 papers in the map (data through 14 Oct 2026).
- Builds on 23 of its 45 references that are in the map.
- First posted on arXiv 2 Feb 2026.

## Builds on (most cited first, 23 of 23)

- [Attention Is All You Need](https://mlsanity.com/paper/1706.03762/) (2017)
- [Deep Residual Learning for Image Recognition](https://mlsanity.com/paper/1512.03385/) (2015)
- [An Image is Worth 16x16 Words: Transformers for Image Recognition at Scale](https://mlsanity.com/paper/2010.11929/) (2020)
- [Faster R-CNN: Towards Real-Time Object Detection with Region Proposal Networks](https://mlsanity.com/paper/1506.01497/) (2015)
- [DINOv2: Learning Robust Visual Features without Supervision](https://mlsanity.com/paper/2304.07193/) (2023)
- [XGBoost: A Scalable Tree Boosting System](https://mlsanity.com/paper/1603.02754/) (2016)
- [You Only Look Once: Unified, Real-Time Object Detection](https://mlsanity.com/paper/1506.02640/) (2015)
- [Attention-based Deep Multiple Instance Learning](https://mlsanity.com/paper/1802.04712/) (2018)
- [Data Efficient and Weakly Supervised Computational Pathology on Whole Slide Images](https://mlsanity.com/paper/2004.09666/) (2020)
- [Dual-stream Multiple Instance Learning Network for Whole Slide Image Classification with Self-supervised Contrastive Learning](https://mlsanity.com/paper/2011.08939/) (2020)
- [Histopathology Whole Slide Image Analysis with Heterogeneous Graph Representation Learning](https://mlsanity.com/paper/2307.04189/) (2023)
- [WsiCaption: Multiple Instance Generation of Pathology Reports for Gigapixel Whole-Slide Images](https://mlsanity.com/paper/2311.16480/) (2023)
- [xMIL: Insightful Explanations for Multiple Instance Learning in Histopathology](https://mlsanity.com/paper/2406.04280/) (2024)
- [CADICA: a new dataset for coronary artery disease detection by using invasive coronary angiography](https://mlsanity.com/paper/2402.00570/) (2024)
- [Effectiveness of Hierarchical Softmax in Large Scale Classification Tasks](https://mlsanity.com/paper/1812.05737/) (2018)
- [SCMIL: Sparse Context-aware Multiple Instance Learning for Predicting Cancer Survival Probability Distribution in Whole Slide Images](https://mlsanity.com/paper/2407.00664/) (2024)
- [RetMIL: Retentive Multiple Instance Learning for Histopathological Whole Slide Image Classification](https://mlsanity.com/paper/2403.10858/) (2024)
- [From Correlation to Causation: Max-Pooling-Based Multi-Instance Learning Leads to More Robust Whole Slide Image Classification](https://mlsanity.com/paper/2408.09449/) (2024)
- [Automated Detection of Coronary Artery Stenosis in X-ray Angiography using Deep Neural Networks](https://mlsanity.com/paper/2103.02969/) (2021)
- [Multi-Scale Relational Graph Convolutional Network for Multiple Instance Learning in Histopathology Images](https://mlsanity.com/paper/2212.08781/) (2022)
- [Comparing the Max and Noisy-Or Pooling Functions in Multiple Instance Learning for Weakly Supervised Sequence Learning Tasks](https://mlsanity.com/paper/1804.01146/) (2018)
- [Direct Quantification for Coronary Artery Stenosis Using Multiview Learning](https://mlsanity.com/paper/1907.10032/) (2019)
- [SSASS: Semi-Supervised Approach for Stenosis Segmentation](https://mlsanity.com/paper/2311.10281/) (2023)

## Built on by (most cited first, 1 of 1)

- [Cross-Modal Contrastive Learning of ECG and Angiography Representations for Severe Stenosis Classification](https://mlsanity.com/paper/2606.02605/) (2026)

## Abstract (arXiv)

Coronary artery stenosis is a leading cause of cardiovascular disease, diagnosed by analyzing the coronary arteries from multiple angiography views. Although numerous deep-learning models have been proposed for stenosis detection from a single angiography view, their performance heavily relies on expensive view-level annotations, which are often not readily available in hospital systems. Moreover, these models fail to capture the temporal dynamics and dependencies among multiple views, which are crucial for clinical diagnosis. To address this, we propose SegmentMIL, a transformer-based multi-view multiple-instance learning framework for patient-level stenosis classification. Trained on a real-world clinical dataset, using patient-level supervision and without any view-level annotations, SegmentMIL jointly predicts the presence of stenosis and localizes the affected anatomical region, distinguishing between the right and left coronary arteries and their respective segments. SegmentMIL obtains high performance on internal and external evaluations and outperforms both view-level models and classical MIL baselines, underscoring its potential as a clinically viable and scalable solution for coronary stenosis diagnosis. Our code is available at https://github.com/NikolaCenic/mil-stenosis.